Abstract
Background: Currently, the treatment of primary bone sarcoma has been developed to increase survival rate and enable patients to undergo limp sparing surgery. The cost-utility study of reconstructive surgery methods could also benefit developing treatment plans as well as national policies. Materials and Methods: The present research was conducted among 27 patients with primary bone sarcoma of the knee undergoing limp sparing surgery by analyzing the cost-utility of various biologic versus endoprosthesis reconstruction. The result reported in the quality-adjusted-life years (QALY), cost per year of well-being (Cost/QALY), ratio of additional sanitary years (QALY gain), and creating alternatives to adjust costs to an acceptable range with one-way sensitivity analysis. Results: The QALY of endoprosthesis was the highest at 5.316 years, while the lowest number was recycled bone autograft at 3.712 years. Compared with the Cost/QALY, the recycled bone autograft indicated the most breakeven method, while endoprosthesis showed the lowest. For analyzing by QALY gain, the additional investment totaled 171,314.27 THB. Conclusion: Prosthesis as a good option, have side effects and the highest number of QALY but did not breakeven. However, reducing the cost by 27.004% was almost the same as the most breakeven method. For this method, an additional investment, equivalent to the minimum wage in Thai law averaging within 1 year, was not needed because this extra investment cost only about the minimum Thai civil servant salary for 1 year. Keywords: Primary bone sarcoma of the knee; Bone reconstruction around the knee; Cost-utility analysis; Various biologic versus endoprosthesis reconstruction
Published Version
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